Joanne Kwak-Kim

Dr. Kwak-Kim provided quite in-depth testing and identified some genetic blood clotting factors that other testing did not catch. Her plan is very thorough and addresses each medical issue that I present with. I wish that I had more time to consult or hear from the doctor and not just exclusively work with the nurse practitioner.

Be prepared to have IVIG recommended as a main main part of your treatment plan. IVIG is expensive out-of-pocket if insurance doesn’t cover it which it most often does not. This has cost us a lot of stress financially feeling that we have to pay out of pocket in order to keep the pregnancy healthy. ( this is obviously based on my results ).

I am currently on Metformin Lovenox Progesterone Estrodial Levothyroxine Plaquinel Prednisone IVIG I have driven down 5 times to assess blood flow by ultrasound as well.

My insurance is covering a large portion of my visits and testing however I do have a $20 co-pay for each office visit and I am just now receiving lab bills that I have approximately add it up to around $300. Every week to every two weeks I have had to send my blood by FedEx overnight to the clinic to run my NK Assay. The shipping cost around $70 overnight. The largest cruel of cost has been with that IVIG, I had one infusion at the clinic which ran around $3500 and one infusion at home which ran approximately $4000. We are early on in our pregnancy and the cost was over one month.

Dr. KK is a fantastic researcher and very knowledgeable in her field. She studied under the pioneer, Dr. Alan Beer, and even worked under him in the earlier days. She is cautious (good & bad), but mostly for the purpose of preserving your overall health, not just do anything to get you a baby at the expense of your health. She doesn't do the "kitchen sink" approach, rather gives you safe & effective options, though maybe not always the most aggressive. This is enough for most, though maybe not all. She's pretty straightforward about her thoughts, she definitely doesn't sugar coat, but she won't lead you on with false promises either. She deeply cares about her patients, but not the touchy feeling type at all. She is very busy though between running the clinic, overseeing the lab, presenting research at conferences, etc. so don't expect to be getting a lot of direct attention from her, but you can definitely get her time by making an appointment with her.

She's not the dr you want if you're looking for a kitchen sink approach, but perfect if you're looking for someone who is incredibly knowledgeable, thorough, and balances your long-term health with helping you have a baby.

She doesn't do IVF or IUI, only immune protocol. She will make recommendations on your IUI/IVF cycle if you and/or your RE want her to, but otherwise she primarily starts once you are pregnant and mostly only does some bloodflow and immune checks prior to transfer. She uses a lot of prednisone, IVIG, lovenox, BA, supplements, heparin, planquil, metformin and will sometimes also use Enbrel, Humira, and a few other drugs. Doesn't use intralipids (doesn't believe in its effectiveness) or Neupogen (believes it's too risky)

The initial work-up is expensive, up to 5K if ins doesn't cover anything including labs. After that, you pay for what services you use. There's a 1 follow-up requirement per trimester. If you use portal to replace in-person/telephone follow-ups, there's a periodic charge.

Dr. Kwak-Kim meets with patients on their first visit. The NP typically handles subsequent patient visits but keeps Dr. Kwak-Kim apprised of the situation. One example of the excellent care and responsiveness from Dr. Kwak-Kim is as follows: I was taking Lovenox injections twice daily and one of my injection sites didn't clot. After 15 hours of bleeding, I called the after-hours number on a Saturday night and spoke to an answering service person. Dr. Kwak-Kim returned the call to me herself in less than 30 minutes. She was familiar with my protocol, knew what meds I was taking, and told me how to handle the situation. She also called in blood tests that I needed to have drawn the next day. I was so impressed with her attention to detail and the personal way she handled the situation. I was worried about bothering her or her staff on a Saturday night but she assured me that I did the right thing by calling in about the injection site not clotting.

Dr. Kwak-Kim can be difficult to understand due to her accent, so be prepared to ask follow up questions and request a summary in writing.

I was on low dose aspirin, claritin, metformin, and a variety of supplements for the duration of my treatment cycles and pregnancy. During the treatment cycles, I was on Letrozole, Follistim, Ovidrel for the trigger, IVIg, prednisone, Prometrium after ovulation, and Lovenox once daily. After pregnancy was achieved, I was on progesterone support (Progesterone in oil shots and prometrium), estrogen support (estradiol tablets and patches), prednisone, IVIg infusions, and continued the low dose aspirin, claritin, metformin, and supplements. I had issues with high NK cells and inflammation levels. My blood clotting factor was also higher than normal, which had been undiagnosed by previous fertility doctors. Dr. Kwak-Kim also diagnosed with Hashimotos, which was missed by pervious doctors, as well. I feel like her tests are so thorough and her approach to treatment covers all of the bases. I felt like it was a lot of medication but each drug had a specific purpose for my particular situation. Dr. Kwak-Kim made sure that I was monitored closely, with blood work at least weekly to check thyroid and hormone levels. Adjustments were made to my medication doses every week based on the blood draw results. After a complicated pregnancy, we ended up with a perfectly healthy daughter born at 38 weeks.

The billing staff were great at billing my insurance and coding the procedures as medical rather than infertility. Many of the appointments (except for the phone appointments) were covered, the ultrasounds were covered, the administration of the IVIG infusions were covered. We did the blood work remotely so it was covered by my insurance. I had to send vials of blood via overnight mail to RFU labs for specific tests twice a month. None of that was covered by my insurance, so it ended up being around $250 twice a month for those tests. Additionally, we ran into some issues with my insurance not wanting to cover the IVIG medication. At $3000 for 30 grams, that added up quickly. Laurie was great at helping me with appeals and we were successful at getting some it covered.

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She is highly specialized and knowledgeable. I greatly appreciate that she approaches the patient very wholisticly and looks how everything is connected and can impact your ability to get and stay pregnant.

Ask lots of questions and know she is very research based and won’t give you something if she thinks it will compromise your health

Due to multiple miscarriages and immune issues I was put on immune protocol with IVIG, prednisone, progesterone, estrogen, and metformin. They closely modified my drugs based on regular blood tests.

Costs were extremely reasonable

Dr Kwak-kim is very knowledgeable. When I emailed her directly about a problem with her staff she ignored me and her office manager dropped me as a patient when I was pregnant and on their protocol. I consider this a liability since they wouldn't bridge the gap from when I was able to get in with a reproduce immunologist is Michigan.

Be your own advocate. The front desk sometimes won't schedule follow-ups when you need lab results before transfer

I didn't have enough blood flow to my uterus so the Dr put me on lovenox. Also, my PA-1 gene was mutated so was put on metformin. Also, my regimen included progesterone in oil, prometrium, estrace, vitamin D, Vitamin E, baby aspirin, and metanx.

Most of my procedures and lab draws were covered under my insurance