John Hesla

He has a ton of experience and was very clear about what should / was occurring. He backed his choices with the latest research and was realistic about the options / chances we had. I preferred his direct explainations to vague statements. He was open to other options. We had unexplained infertility. With Dr. Hesla, we did a cycle where the eggs were split into 2 cohorts. One cohort was fertilized with my husband's sperm and the other cohort with a donor. It was the easiest and least expensive way to hedge our bets in case some part of the issue was sperm based or just an interaction between my husband and I. Some doctors we had spoke with were uncomfortable with that idea. We had 2 successes with the sperm donor embryos despite the unexplained infertility diagnosis.

He will be direct and explain the chances of failure and success. You'll either really like that or really won't.

It's been a couple years so I don't recall the exact protocols. I did have to switch vaginal progesterone due to a reaction to the oil, and used the pre-mixed trigger shot for the same reason. We also did a modified natural transfer instead of forcing the hormones. We split the eggs retrieved into two groups - one fertilized by sperm donor and one with my husband's sperm in order to increase the changes of success. He was amenable to that, where some doctors weren't when interviewing them. We did cancel one FET due to low levels of one of the hormones and when I asked, he sent me the studies that supported that - so it wasn't just about how he felt about protocols but rather research.

Costs were higher than many clinics if I recall correctly, but they had good success rates and were very close to us.

He supported both and allowed us to determine it after presenting the information. We did multiple (2) embryo transfers for our 3 transfers with him. 2 of the 3 resulted in single births.

Dr. Hesla was kind and did answer all of my questions. I think he is a good doctor but he isn’t at a good clinic. I did like that he would listen to and consider options that I brought up. I also wish they were more up to date with emerging science and treatments.

Take a note pad because he gives great information. Make sure to write down any questions before you meet with him so you don’t forget to ask.

Dr. Hesla suggested I keep taking prenatal vitamins with folic acid and also suggested I take Ovasitol. He said he suggests me trying 4 cycles of timed intercourse with Letrozole and statistically if it doesn’t work by the 4th time, I’ll need to move to the next step which is IVF. For reference I’m 35 with PCOS and my husbands sperm is above average quality. Fast forward, that didn’t work so we did 3 egg retrievals, 2 transfers, and 1 embryo didn’t survive thaw. We did change up the protocol each time but didn’t get better results. On the 3rd retrieval we used human growth hormone but results were similar/not great.

$80k for 3 retrievals, 2 transfers, and 2 mock transfers for uterine biopsies.

He did not go into details about that but did say that chances of success don’t increase much by doing multiples.

When I came to Dr. Hesla to start the IVF process I was very scared. I had already been through the IVF process once and it ended in a miscarriage. I so desperately wanted the process to work and to not feel the pain that I had gone through before. From the very fist consultation with Dr. Hesla I felt at ease. Dr. Hesla is soft spoken and very calming, he was willing to spend time with my husband and I answering questions and making sure we felt comfortable with the plan prior to moving forward and once we started the process he has there every step of the way and I felt like he really cared about me and wanted this process to be successful.

Ask questions! Make a list before you go in for an appointment so you have something to reference. I tended to get very anxious and nervous for each appointment and would forget things that I wanted clarity on or concerns I had.

Delestrogen No Lupron FET.

$25,000 or more

For him it depends, usually, no more than two embryos transferred at a time.

I have only seen Dr Hesla once so far during our consultation. For my other appointments and procedures I’ve seen a nurse practitioner. During the consultation Dr Hesla took time to get to know us but did not ask many personal questions. I do feel he took time to look through our previous charts/labs and talked through them. He did answer our questions but did not provide any real new information. I appreciated his willingness to start treatment right away and not wanting to redo a bunch of tests. Dr Hesla is very knowledgeable and factual but not emotional.

For IUI took 5mg of letrozole for 5 days. Went in for ultrasound before ovulation to check progress. Did trigger shot and then IUI 36 hours later.

Have not received a bill for ultrasound or labs yet as they are going through insurance. Trigger shot was $175 out of pocket as insurance doesn’t cover. IUI was around $450 due at time of appointment, which they did not communicate before the appt.

Dr Helsa is a good doctor who approaches the protocol in a methodical manner. He explained everything well and worked around the egg donors schedule so accommodating her schedule. He has a gentle manner but does not beat around the bush and straightforward in his approach which I prefer. His views are based on facts and experience but perhaps sometimes I would've like more of his own personal opinion.

To make sure they like a no-nonsense approach and be willing to hear it like it is.

My (fourth) egg donor who did this cycle last month with Dr Hesla was given Merapur, Gonal F, Cetrotide, Dexamethasone, Aspirin 81mg, Theranatal vitamins and the birth control pill. My egg donor did her initial screening in Mexico City was also given the trigger injection and instead of starting her Cetrotide injection she accidentally gave herself the Ovidrel trigger injection before flying to see Dr Hesla. Unfortunately Dr Hesla confirmed with the blood test that indeed she had given herself the trigger injection and recommended cancelling the cycle as the eggs were too tiny to be retrieved. The donor has since decided she doesn't want to do another cycle although she promised she would as she admits this has been a very costly mistake due to her error.

I was given a Promise Package of $30,300 which meant inclusive of all embryo transfers until all embryos were used up but no refund would be given if the attempt failed. Medications would depend on the next cycle and what is needed. Unfortunately as the cycle had to be cancelled due to my egg donor accidentally giving herself the trigger injection instead of the Cetrotide, I was only billed for the the psychological evaluations and genetic counsellor's evaluations so far which was $860. All the medications and ultrasounds I paid directly to the doctors and the clinic that was monitoring my donor in Mexico City which was around $16,000. I paid for egg donor insurance directly to ArtRisk, travel insurance, hotel, flight, expenses directly to the relevant parties.

Dr Hesla recommends only one embryo to be transferred at a time but as my husband and I have gone though now 11 IVF's (or let's ay 10.5 because of the cancelled cycle due to the egg donor's mistake) we would prefer to have 2 embryos as this will be the 12th and last time we will attempt to start our family.

Extremely knowledgeable, completely confident in his wisdom, insight, and protocols. Will move along quickly if you don’t have questions so be forward with any questions. When you do ask, he is very thorough. He deferred to my PCP a couple times due to unexpected complications, which caused my care to feel disjointed at those times, but overall he is a great doctor.

If you ask questions you will get thoughtful and thorough answers.

I have PCOS so he watched very carefully so I would not hyperstimulate but was also sensitive to the fact that the egg quality was likely not great. He adjusted dosages/treatment length to accommodate (upping Follistim when follicles were not growing, then tapered off once they started developing quicker). Because of the amount of eggs (31 at retrieval) and symptoms of overstimulation he called for a freeze-all and a month to get my body back to baseline.

Around $30,000 though we are not pregnant yet.

I did not feel like Dr. Hesla pushed either way for one or two embryos. He answered our questions, offered neutral and data-based reasoning for both options, and supported our choice without hesitation.

He made sure to explain the entire process in detail and made sure all of our questions and concerns were addressed. When explaining the options he explained why they would be best for me or if anything needed to be adjusted to fit me specifically. He communicates well with us and to his team which makes things flow smoothly. He has been very sensitive with what we are going through which I greatly appreciate since we are new to all of this.

This whole process is extremely overwhelming but they understand that and will take the time to answer any questions and address any concerns so don’t be scared to ask.

I am newer to this so we have not started into the more intense treatments yet. We have started with low dose Clomid, we are specifically staying at the low dose due to my other health risks and wanting to keep the chance of multiples to a minimum. The first round did not take but before starting me on another round of clomid we are going to do another baseline scan to make sure I have not developed anymore cysts since I had one on my first baseline scan. I hope I don’t have one since that would mean pushing thing off yet another month but I am glad he is being so cautious for my health. I know that he is truly trying to get the best outcome possible even if it means having to put things on hold for a bit.

I cannot remember off the top of my head but after your consult appointment you have a phone appointment with their financial department to discuss coverage, payment options, grants, and costs of everything. I really like that they give you an itemized list of every test, procedure, visit with the cost and if it is done in house or not. It was nice seeing at our very first appointment what every single thing would cost, this is rare to find in anything healthcare related.

I do not know me doctors preference yet for this for other but I know for me and my health he is only recommending a single embryo transfer.

We have only met once but his communication and listening to what we shared without us feeling rushed made us feel heard and that we were transferring into good hands from our previous doctor. They have very similar mannerisms of listening and having confidence in the work they have done, This made us very comfortable.

Find joy in your journey!

Too early to tell.

The costs are expected to be about 10,000 per cycle. We have paid 3500 up front and then as we go through the cycle we will pay the rest and medications.

Multiple embryo transfer due to the age of the donated embryo egg donor as well as my age. We are in full agreement with him on this and felt very comfortable when the time comes for the transfer.

Dr Hesla went over my complex history fully. He listened to my concerns and needs. He helped me to see two high risk OB’s for additional opinions if I should carry a pregnancy. He was always ready to answer questions and give details about treatment. I appreciated that he was always willing to give information on current research in the field to help us feel like we understood our best, most up to date options. He was kind and supportive through our hardest moments.

Ask questions

Our protocol seemed pretty straight forward. I don’t recall doses, but we were able to monitor locally.

Each time we were given a clear estimate of costs for retrieval, medicine, monitoring, transfers, and storage.

Dr Hesla provided appropriate information on the value of eSET. All of our transfers were single embryo transfers.

Dr. Hesla has a wonderful way of using facts and science to give you a realistic expectation of treatment, but he does so in a kind manner that I appreciate, even when the news isn't great. He is thorough and detail-oriented. He also welcomed my questions and agreed to try procedures that could potentially improve chances at my request.

He is not an outgoing teddy bear or anything, but he is so smart and so compassionate. Go in prepared to speak with a professional who will do everything he can, but lean on your therapist or partner or mom for comfort :)

Cycle 1: Baseline ultrasound. Clomid 50mg on days 3-7 which produced one 29mm follicle, IUI timed with positive OPK. No pregnancy that cycle. Cycle 2: Got a cyst from the Clomid, had to pause treatment and wait for the cyst to go away. Cycle 3: Baseline ultrasound showed cyst was gone. Clomid 100mg on days 3-7, which produced 2 follicles over 20mm (our goal). IUI timed with positive OPK, still waiting on results. Will be switching to Femara for future treatment (if more rounds are required) based on my response to Clomid.

My insurance covers everything until IVF 100%. I've been paying a $40 copay per visit, plus $99 for each semen analysis, since that lab is considered "Out of Network" for all insurance agencies.

Not yet applicable.

I was only on-site at the clinic for the donor FETs, as we live in a different state. But each time he seemed fully comfortable with my case, my history, etc. Always asked about my husband & kids. Never left the room until I said all my questions were answered.

Absolutely go for it, he's fantastic.

All 4 donor FETs were identical protocols. Only difference being dosage changes as my bloodwork dictated each time. Birth control, followed by Lupron. Delestrogen twice/wk. Progesterone in oil beginning 6 days prior to transfer, continuing through the first trimester. Prometrium suppositories beginning after positive pregnancy test. Baby aspirin and prenatal vitamins for the entire cycle/pregnancy.

Approximately $2500 per FET, not counting medications.

Our donor embryos were frozen in pairs, and due to our religious beliefs, we did not want them refrozen. He allowed us to transfer 2 embryos each time because of this, despite birthing twins following the first transfer.

PROS: Dr.John Hesla is a very compassionate man he showed me that he cares. Being a patient there for a while,I became like part of his family in a way,he got to know me as a patient. He has a tender voice that its not intimidating and at times, I felt reassure just with a smile from him. The only small CONS: is Dr.John Hesla is a busy Dr. at times I felt rushed through appts with him and not all my questions were answered.

I would say don't be shy to ask as many questions as you like,speak up if you feel you are being rushed out, because you want to leave the place inform not with questions all the time..

My protocol was always the same I belief conventional with antagonis: consist Follistum ,menupor Ganirelix trigger with HCG Novarel. I wish he tried a different protocol. It did help a 3 years ago and got a baby girl, but as I get older I think perhaps he should of try a different protocol agonist ,Lupron etc .

Last year alone in 2017 cost of IVF/ meds over 26K over the years easly spend 40K+

always 2 embroys to transfer

I can't overstate how much I appreciate Dr.Hesla's care. From after hours follow up phone calls, to coming in on weekends (when he's NOT on) to see me at appointments, he has gone out of his way on many occasions to be sure I'm cared for. He opens his schedule early or stays late if necessary- and does so in an incredibly gracious way, without making me feel like a burden. I'd recommend him to anyone.

You'll be seeing his NPs for routine visits, but he will always make time for you when you need him.

I have never had a positive pregnancy test under Dr. Heslas care, and continue to hold the "unexplained infertility " diagnosis. We have tried natural and medicated cycles, single and multiple embryo transfers, using prednisone/antihistamines post transfer.... just no luck so far.

Retrieval w fresh transfer and CCS testing on remaining embryos $10k FET $1200

He will not transfer more than two embryos.

Strengths: he really seems like he is an expert at difficult cases like ours. Explained his rationale for choosing certain protocols, and then admitted when things didn't go as expected. Weaknesses: I wish we could have connected on a more personal level, but working with him felt more clinical and matter-of-fact than cold.

I think he holds your case more than holding your hand when you work with him.

1. Birth control with long Lupron: Lupron, Menopur, Follistim. Cycle canceled due to poor response. 2. Antagonist without BCPs. Menopur and Follistim, also with Dexamethasone. Added Ganirelix at the end.

Spendy, but they are very upfront about their costs. I believe we had a $20,000 up front bill that was then reduced from. In the end we actually got some money back because we had planned to do genetic testing on embryos, but never had any extra to test.

He was very honest and straightforward but warm and caring. He would present information very neutrally, giving you facts with no bias. Then offer his opinion but never felt judgemental. I also never felt rushed with him. He always took the time to answer questions.

Feel free to ask him anything. He will answer honestly.

Hard to remember details even though I lived and breathed them at the time. If feel the first Roy d I was offered a natural cycle (less meds -because I still had a very healthy cycle) or what I would call a very straightforward protocol. I was too scared to do the natural one. I felt the straightforward approach would assist more. I had a miscarriage and then next round did more of an allergy protocol. It included Claritin and antihistamine and some other drugs that was to help the body not attack the embryo. But not heparin or anything to that degree.

Most of my monitoring was done in Ny.

I feel like the 1 retrieval and 2 transfers was 30,000 more or less. That included genetic testing and icsi

He is overall a very good doctor. I think he lacks communication skills which can be frustrating. As I stated previously, he almost never made eye contact and seemed unable or unwilling to answer questions directly. I had limited access to him as a patient. All my questions for him were relayed through my nurse. In order to speak with him directly with questions, I had to set up an expensive appointment. My situation is complicated and Dr Hesla was not able to help us conceive. We had unexpectedly bad IVF results -- everyone was shocked. He ran a few tests that seemed to make sense but didn't really know how to advise us on next steps based on the results of the tests. He basically shrugged his shoulders and wished us luck. We ended up going to a different clinic. He didn't have a lot to offer a complicated case. I think for simpler situations he's probably great.

If you have a relatively straightforward case of infertility, Dr Hesla can probably help you. If your case is complicated, I would seek a different clinic. He is the most experienced and knowledgable doctor at the clinic but the clinic itself has its limitations. I would also advise prospective patients that they should be prepared to receive a clinical and slightly cold demeanor from Dr Hesla. He didn't seem capable of or interested in showing a great deal of compassion.

I started with a straightforward IVF cycle: BCP followed by 150 Follistim 150 Menopur with a Lupron trigger. I ended up not being suppressed at the suppression check after 1 month fo BCP. I actually got pregnant that cycle naturally and had a miscarriage. After the miscarriage, he put me on Lupron 20 units for suppression then 10 units during stims along with 150 Follistim 150 Menopur. I think the protocol was over-suppressing for me but it did make sense as a first IVF.

ORM is a fairly expensive clinic. I think our IVF cycle came to roughly $17K.

Dr hesla is talented and was informative about my low ovarian reserve condition. He gave us a less than 5 percent success rate because of my age and condition. He recommended PDG but because I had been able to obtain two or three embryos in the past, I declined. I explained that it wasn't worth the money with so few embryos and he agreed. I appreciate that he considered my thoughts on that procedure. He is very brisk in his bed side manners. However, that never bothered me. I am only interested in results. He was able to get me the highest number of embryos with the best quality. I now have a two year old daughter and a frozen embryo that is cryofrozen. I can't recommend him enough.

His manners may be brisk but if that's ok with you, he's an effective endocrinologist.

He prescribed human growth hormone, when that was still allowed in fertility treatments. I don't know whether this was the procedure that did it but i had the most number of embryos with the highest quality among my three fertility cycles.

Around $6000 out of pocket, which wasn't covered by insurance. I think total amount was around $25000.

By the time I had my first consultation visit with Dr. Hesla, I had been through a lot -- 2 1/2 years on the pregnancy journey, four failed IVF cycles, and a miscarriage. I was doing this whole thing as a single woman, I was tired and worn down, and I wasn't sure if I could have any more hope of having a baby. I nervously approached the possibility of using a donor egg with Dr. Hesla. From the very first moment, he gave me a sense of possibility and warmly and positively reviewed my case history. He listened well and used just the right amount of gentle humor to lighten what had become a pretty heavy topic. He was not pushy, and it was clear that he did not have a God complex like some RE's do. He was smart, experienced, respectful, warm, positive, and communicative -- in that very first meeting and in every subsequent interaction I had with him (in person, on phone, or via email) over the next 15 months. When I decided soon after that visit that I would in fact pursue conception with a donor egg, he got genuinely excited for me. He was extremely involved in selecting, examining, and green-lighting possible egg donors for me, and ultimately, he was the one who found and matched me with my donor. I had already reserved one woman via an agency that the clinic works with closely, but became hesitant when they cycle she did before working with me didn't go that well. I remember Dr. Hesla wrote to me and said he had found someone he thought would be a terrific donor match for me. He said "she's 28, lovely and smart, beautiful like you, and has had great results in a past cycle." It was so kind the way he did it -- and I did end up going with that donor, to great success. I'll never forget the experience of my transfer for this final and successful cycle. As I lay on the table in the transfer room (like an OR?), classical music played softly and the lights were dimmed so that the environment was as relaxing as possible. Dr. Hesla came in wearing his scrubs, of course, greeted me, and then went to the side of the room where there was a pass-through window to the embryology lab. When the embryologist passed the tube containing the embryo that was to be transferred, Dr. Hesla received it gently in two outstretched hands as if he were being handed the last butterfly on earth -- and he walked back across the room holding it with such care and reverence that you could see it. Two nurses stood near where I lay, and the embryologist came into the room and held my hand for the entire procedure. It sounds ridiculous or over-the-top to say this, but truly, they made a medical procedure feel sacred. This was (and is) the caring the humanity of the team at ORM.

I live in New York City, and had worked with a local doctor for four unsuccessful cycles before opting to work with a clinic on the West coast, ORM, and Dr. Hesla. The advice I would give a prospective patient who is having trouble conceiving in another part of the country would be: don't wait and only travel to work with Dr. Hesla after you have put yourself through possibly unnecessary pain and hardship. Go to him sooner.

Because I was 44 and, despite high doses of "stim" meds had had four unsuccessful IVF cycles, Dr. Hesla concurred early in my first consultation with him that, if I was willing, donor egg would be the right strategy for me. Back then, I used to be able to recite every detail of every protocol for every cycle -- but, blessedly, years later and with a sublime 8-year-old boy who is the light of my life, I can't remember the exact medication protocol. But since it was my egg donor who was getting the stim meds and doing the egg retrieval, my protocol was simply to sync with her cycle and then build my uterine lining. I do remember that while all IVF cycles involve progesterone injections after transfer, Dr. Hesla was especially aggressive with progesterone and prescribed both the injections and progesterone suppositories for several days (can't remember how long). He said "we've gone to a lot of trouble to get you this far, so I don't take any chances."

I don't remember exactly -- it's a blur of high expenses, obviously. I think that they cycle probably cost somewhere around $10,000, but then of course I had additional expenses to the donor agency, the acupuncturist, travel between New York City and Portland, hotel in Portland, etc.

Deciding whether to transfer one or two embryos was one of the hardest decisions I've ever had to make in my entire life. The reason was, as a single woman, I was terrified of having twins, which would have been more than I could handle or afford. Using my own eggs, which were of lesser quality, I always transferred as many embryos as looked good even to get one possible implantation. But since my ultimate cycle was a donor egg cycle, I knew the embryos were grade A and healthy, so there was far more likelihood of success for each and every one of them. I was scared to transfer 2 and end up with 2, but I was also tremendously scared to do an eSET and end up with 0 -- in this, my absolutely final cycle that I would ever do. Dr. Hesla was extremely understanding and talked this decision through with me fully. He told me ORM's stats for eSETs and told me that while it was fully up to me, the quality of my embryos were good enough that he would endorse either decision. I rolled the dice and went with a eSET -- and was rewarded with a solid implantation and very healthy pregnancy.

Dr. Hesla was one of the very first care providers that I have had that said to me with great confidence that conceiving was very possible using donor eggs. He admitted to me with my past track record of miscarriages that keeping me pregnant would be a challenge – but together we could succeed. He gave both my husband and I hope. He is very confident in his ability. We found him to be brilliant - he thinks outside the box and we liked that very much. He was warm and compassionate. I didn't feel like a number and his office. I felt valued. He was almost as excited about us having a baby as we were!

Don't be put off if you have to wait to see him - meaning if it takes a bit to get into his office it's well worth the wait. It's helpful to have your questions ready to ask during your appointment. And he is very accommodating at answering the questions presented to him in a very thoughtful and patient manner. He doesn't gloss over anything. He's very detail oriented. And me being an anxious person I got to the point where I actually manage my anxiety very well and would not get overly concerned about anything unless he became concerned. We trusted him that much.

This was my first Egg Donation cycle. I knew nothing about protocols and I really had to trust my doctor and this clinic to lead me through a successful a donor cycle. They helped me select my donor, which was a big help because I was incredibly overwhelmed by the entire process.

26,000

Dr. Hesla did not pressure us into any specific treatment, but provided us with a good overview of our options. He seems meticulous in the way he prepares patients for treatment. I felt 100% confident that he was going to make sure that every detail was handled. Communication was excellent when we needed to talk to him.

You can ask as many questions as you want.

I have not yet begun treatment.

For a cycle of IVF with PGT-A and meds it was about 25k.

Emphasis on single

Dr Hesla strikes me as pretty hands off. He's very official and seems experienced, but I doubt he would remember who I am at this point. I've only actually seen him twice; most of my appointments have been with NPs.

Have an idea of how you want to do things before you go in. Keep in mind your needs and advocate for yourself.

We did two medicated IUI rounds so far. I was on 2 2.5mg tablets of letrozole for days 3 through 7 of my cycle to stimulate follicle maturation. Then I had a mid-cycle ultrasound to confirm my follicles had responded and then I was prescribed a trigger shot to trigger ovulation. I don't remember exactly what type it was.

The ultrasounds were approximately 275 each time. The letrozole was free with my insurance. The trigger shot was $500. The IUI was about 300 to 350 including the sperm defrosting and quality check.

Dr. Hesla is very intelligent and thorough. He has a plan, and communicates it well during appointments and consultations. He is articulate and warm, and always friendly. I feel like I am respected and that none of my questions are considered a “waste of time” or “stupid.” I trust Hesla with my continuing care.

I did two cycles with Clomid, and 3 with Letrozole to increase my follicle amounts. I also used a trigger 4 or 5 times to force ovulation. I produced 1-2 follicles each cycle and had one pregnancy that resulted in a miscarriage. I have diminished ovarian reserve and may be proceeding with IVF next cycle.

Dr. Hesla is kind, soft spoken, and very caring. He views you as a person first and provides choices. Though this can sometimes be frustrating when expert opinion should be utilized, it is great to be provided with all of the information

If you have an expectation on treatment, communicate this from the start. If you want his expert opinion, you may have to ask several times

Total- 60k

Dr. Hesla explained the risks/ benefit based on our situation and his recommendation for singleton

I was referred to him by PVED and it was an excellent decision. Great clinic, and great stats for donor egg. John Hesla was honest with us, and when we had a major setback (1st donor had bad eggs), John adjusted course quickly and now we have a beautiful child and several tested frozen embryos.

None. He's everything I wanted in an RE

We did two IVF stim cycles with him, with two different donors The first donor had poor egg quality, and the second donor had outstanding egg quantity and quality. Our first transfer worked and now we have a beautiful toddler. Our experience was that John Hesla was an excellent doctor and the clinic was well run.

Don't remember exact numbers, just that it was in line with other IVF clinics. Less expensive than CCRM, about as expensive as Seattle Reproductive Medicine

After the first visit, appropriate AMH and other testing was done to determine the best course of action. He was very efficient and committed to the process of having treatment end with a successful birth.

You are in good hands.

We did a straightforward donor egg cycle, so I did shots for a few weeks beforehand.

In line with other clinics.